Email *

Child Date of birth *

If they were premature, please identify their adjusted age. This assessment goes off of adjusted ages.

How would you describe your baby's muscle tone (how their body feels when you touch or hold them)?

Floppy/ Wet Noodle

Tight/Rigid

Somewhere in between

My toddler is able to move in and out of the standing position with use of furniture around them.

True

False

My toddler is cruising (walking) along furniture, including around corners.

True

False

My toddler is confident with letting go for a few seconds at a time when in a standing position.

True

False

My toddler is taking several, unassisted steps at a time.

True

False

My toddler's walking pattern can be described as the following:

Launch mode: I keep my hands open constantly and surround them with soft furniture

Toe walking (up on tiptoes constantly)

Controlled: They can stop on their own or with just a little help

My toddler can squat down to pick something up when holding onto something supportive.

True

False

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